HSE Planning and Performance Committee Meeting Minutes 26 May 2023

Committee Members Present: Fergus Finlay (Chair), Brendan Whelan, Anne Carrigy, Sarah McLoughlin, Sarah Barry, Joan Johnston.

HSE Executive Attendance: Damien McCallion (COO), Yvonne O’Neill (ND Community Operations), Robert Kidd (AND Acute Operations), Joe Ryan (ND Operational Performance and Integration), Orla Treacy (Operational Performance and Integration), Tony Canavan (CEO Saolta Hospital Group), Sara Maxwell (Office of the CEO), Dara Purcell (Corporate Secretary), Niamh Drew (Deputy Corporate Secretary), Rebecca Kennedy (Office of the Board).

Joined the Meeting: Mark Brennock (ND Communications – Item 2.3), Patrick Lynch (CRO – Item 5).

Minutes reflect the order in which items were considered and are numbered in accordance with the original agenda. All performance/activity data used in this document refers to the latest information available at the time.

The Committee held a private session to review the agenda, the relevant papers and approach to conducting the meeting, noting that the focus of the meeting would be to receive updates on key items and to suggest relevant actions as they became apparent.

The Chair welcomed executive members to the meeting.

2.1 Declarations of Interest

No conflicts of interest were declared.

2.2 Minutes of Committee Meetings

The Committee approved the following minutes:

• 21 April 2023
• 25 April 2023

2.3 HSE in the News

ND Communications joined the meeting.

The ND Communications provided the Committee with an update on current HSE media coverage, particularly in relation to Disability Services. The Committee highlighted the importance of HSE engagement with those involved and their families and highlighted that unified nationwide communication in relation to available services is critical.

2.4 Roadmap for Service Improvement 2023-2025 Disability Services for Children and Young People

The COO provided a verbal update on the Roadmap for Service Improvement 2023-2025 Disability Services for Children and Young People and confirmed that he would provide a brief written update on the matter at each Committee meeting going forward.

ND Communications left the meeting.

The COO Report, Operational Service Report (March Data), Performance Profile (March Data), National Performance Oversight Group (NPOG) Meeting Notes (March Data), and the PMO Report – Winter/NSP 2022-23, which had been circulated prior to the meeting, were noted.

The COO updated the Committee on the key strategic and operational updates outlined in the above documents, focusing in particular on Cancer Services, Scheduled Care, and Child and Adolescent Mental Health Services (CAMHS). In relation to Cancer Services, the COO advised that increases in demand for cancer services are being seen post-pandemic. The South-South West Hospital Group is focussing efforts to improve availability of Rapid Access prostate clinics. The Committee sought an understanding as to why there was underperformance in this group and the AND Acute Operations advised that it is a combination of capacity and process issues and engagement is ongoing to address these. The Committee also requested an update on the ‘Diagnostics Review’ mentioned by executive members at previous Committee meetings. The COO confirmed that further information will be provided on both of these issues when cancer services comes to the Committee as a focus area at its June meeting.

The COO updated the Committee in relation to CAMHS and confirmed that the full Mental Health Commission review of CAMHS will be published during the summer. He advised that recruitment has been successful for a Clinical and Executive lead for CAMHS and that these leads will be instrumental in implementing recommendations arising from the report. The Committee requested that an update be provided in advance of the report’s publication which the COO confirmed should be possible.

In relation to scheduled care, the COO advised that increased activity is being seen as in growing demand which is in line with global trends. Regarding colonoscopy, the COO advised that issues which were seen in Mayo University Hospital are improving. He confirmed that small issues currently in other sites are being proactively managed. The COO also presented data on Unscheduled Care, National Screening Services, PCRS and Disability Services which was noted by the Committee.

The Committee noted the Urgent and Emergency Care (UEC) papers circulated in advance of the meeting which covered the following:

• existing structures to provide monitoring and oversight of UEC activity
• the HSE Support Team interventions to sites experiencing high congestion levels
• development of surge measures
• the multi-annual UEC plan

The COO updated the Committee on each of the above sections. The Committee discussed in particular the new Multi Annual UEC Plan and its predicted impact on patient safety improvements. The COO confirmed that achieving safer staffing levels is key to the new Multi Annual UEC Plan including management of surge measures, which will be triggered by agreed evidence based indicators which are being developed to mitigate risks during periods of high levels of demand.

The Committee discussed whether there will be provisions in the plan which could change current practices which may be impacting patient flow through EDs. The COO confirmed that there are a number of focus sites across the country which are working to improve waiting times using initiatives which will be considered as part of the Plan. The Committee discussed the data provided and emphasised the importance of a clear flow of patient data within EDs to ensure timely admittance and discharge.

The Committee queried whether data was available in relation to more advanced presentations being seen in EDs as a result of pandemic measures. The COO confirmed that there is anecdotal evidence that this is happening but it is too early to have access to concrete data.

CRO joined the meeting.

The CRO updated the Committee on the Q1 2023 Review of the Corporate Risk Register (CRR). This review is being conducted in line with the ‘Moody’ Risk Report recommendation. The ongoing assessment of each of the HSE corporate risks is expected to result in significant changes being proposed to the risks recorded on the CRR.

The CRO advised that the papers circulated in advance of the meeting relate to the current ‘Stability and transformation of disability services’ Risk. The Committee discussion was based on these papers and covered the following: the historic rating of the risk, reported Risk Event – Risk Source and Risk Impact, Risk Controls, strategic objectives for disability services and focus areas of the current risk review.

The Committee discussed the importance of ensuring that contingencies for the potential occurrence of the risk are captured in the new risk format when developed and expressed their support for the work underway.

CRO left the meeting.

This item was not taken and it was agreed that a briefing on the HSPA Framework would be arranged for the Committee.

No matters arose under this item.

The meeting ended at 13:30.

Terms of Reference: Planning and Performance Committee